“An evaluation of the effectiveness of self-management interventions for people with type 2 diabetes after an acute coronary syndrome: a systematic review”

Mu'ath Tanash, Vivien Coates, Donna Fitzsimons, Christi Deaton

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Abstract

Background: Type 2 diabetes is highly prevalent in patients with acute coronary syndrome and impacts negatively on health outcomes and self-management. Both conditions share similar risk factors. However, there is insufficient evidence on the effectiveness of combined interventions to promote self-management behaviour for people who with diabetes and cardiac problems. Identifying critical features of successful interventions will inform future integrated self-management programmes for patients with both conditions.Objectives: To assess the evidence on the effectiveness of existing interventions to promote self-management behaviour for patients presenting with acute coronary syndrome and type 2 diabetes in secondary care settings and post discharge.Design: We searched Medline, PubMed, CINAHL Plus, PsycInfo, Cochrane Library and AMED for randomised controlled trials published between January 2005 and December 2014. The search was performed using the following search terms of “acute coronary syndrome”, “type 2 diabetes” and “self-management intervention” and their substitutes combined.Results: Out of 4275 articles that were retrieved, only 4 trials met all the inclusion criteria (population, intervention, comparison and outcome) and were analysed. Overall, the results show that providing combined interventions for patients with both conditions including educational sessions supported by multimedia or telecommunication technologies were partially successful in promoting self-management behaviours. Implementation of these combined interventions during patient’s hospitalisation and post discharge was feasible. Intervention group subjects, reported a significant improvement in self-efficacy, level of knowledge, glycated haemoglobin, blood pressure and fasting glucose test. However, there are many threats have been noticed around internal validity of included studies that could compromise the conclusions drawn.Conclusion: With limited research in this area there was no final evidence to support effectiveness of combined interventions to promote self-management behaviour for patients with type 2 diabetes and acute coronary syndrome. Sufficiently powered, good quality, well conducted and reported randomised controlled trials are required.
Original languageEnglish
JournalJournal of Clinical Nursing
Volumeearly
Early online date3 Aug 2016
DOIs
Publication statusE-pub ahead of print - 3 Aug 2016

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Keywords

  • type 2 diabetes
  • coronary heart disease
  • heart disease
  • self-care
  • self-management
  • caring intervention
  • intervention
  • randomised controlled trials

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